Summary & Overview

CPT 0502U: QuantiVirus HPV E6/E7 mRNA Test for Cervical Cancer

CPT code 0502U designates a Proprietary Laboratory Analyses (PLA) molecular diagnostic: the QuantiVirus™ HPV E6/E7 mRNA Test for Cervical Cancer from DiaCarta Inc. The assay identifies high–risk human papillomavirus (HPV) types in cervical cells by detecting E6/E7 mRNA markers via branched–chain capture hybridization and reports a binary positive/negative result. As a PLA code, 0502U applies exclusively to a single manufacturer's test, which has implications for coding specificity, payer recognition, and lab billing practices nationwide.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical application of the test, the service setting, and which major payers are included in the coverage discussion. The publication outlines typical benchmarks used in laboratory reimbursement reviews, payer policy considerations for PLA codes, and the clinical context for HPV E6/E7 mRNA testing in cervical cancer detection.

This summary is intended for a national audience of billing managers, lab directors, and policy analysts seeking clear information on the code's purpose, relevant payers, and the content areas covered in the full publication. Data not available in the input will be identified as such within the detailed sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0502UCPTProprietary Laboratory AnalysesHPV E6/E7 mRNAmolecular diagnosticcervical cancer screeninglaboratory billingPLA code

Billing Code Overview

CPT code 0502U is a Proprietary Laboratory Analyses (PLA) code for the QuantiVirus™ HPV E6/E7 mRNA Test for Cervical Cancer from DiaCarta Inc. The test detects high–risk human papillomavirus (HPV) types in cervical cells by identifying E6/E7 mRNA markers using branched–chain capture hybridization and reports results as positive or negative for high–risk HPV.

Service Type: Molecular diagnostic laboratory test (Proprietary Laboratory Analysis)

Typical Site of Service: Clinical laboratory or reference laboratory

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a sexually active adult woman presenting for cervical cancer screening follow-up after an abnormal Pap test or positive high-risk HPV DNA screening, or for evaluation of persistent cytologic abnormalities. The clinical workflow begins in the outpatient gynecology clinic: a clinician (OB/GYN, family medicine, or women's health nurse practitioner) collects a cervical specimen during speculum exam using a cytobrush/collection device, places the sample in appropriate transport medium, and sends it to DiaCarta Inc. or an authorized reference lab. The lab performs the QuantiVirus™ HPV E6/E7 mRNA Test (0502U) using branched-chain capture hybridization to detect E6/E7 mRNA from high-risk HPV types and reports a binary result (positive/negative) for high-risk HPV. Results are routed back to the ordering provider who documents the finding, informs the patient, and determines next steps (surveillance, colposcopy, biopsy, or treatment) based on clinical guidelines and the patient’s history. Typical site of service is outpatient ambulatory clinic, physician office, or an independent clinical laboratory performing PLA testing.

Coding Specifications

Modifier	Description	When to Use
`00`	Modifier not otherwise specified (proprietary)	Use only if required by payer for proprietary PLA tracking when no other modifier applies.

Taxonomy Code	Specialty	Notes
`207V00000X`	Obstetrics & Gynecology	Common ordering and specimen-collecting specialty for cervical HPV testing.
`207Q00000X`	Family Medicine	Frequently performs screening and orders HPV testing.
`363LF0000X`	Clinical Laboratory	Laboratories performing the technical component and PLA testing.
`167V00000X`	Nurse Practitioner	Women’s health nurse practitioners often collect specimens and order tests.
`1835R0001X`	Pathology	May be involved in interpretation and reporting when cytology/HPV interfaces are needed.

ICD-10 Code	Description	Clinical Relevance
`N87.9`	Cervical dysplasia, unspecified	Represents abnormal cervical epithelial changes prompting HPV E6/E7 mRNA testing to stratify risk.
`R87.619`	Unspecified abnormal cytologic findings in specimen from cervix (Pap smear)	Abnormal cytology results commonly trigger reflex high‑risk HPV testing.
`Z12.4`	Encounter for screening for malignant neoplasm of cervix	Routine cervical cancer screening context where high‑risk HPV testing is performed.
`N72`	Inflammation of cervix (cervicitis)	Cervical inflammation can coexist with HPV testing; clinical context may affect interpretation.
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Used when confirmed malignancy is present; HPV E6/E7 presence is etiologically relevant and may be documented.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0502U`	QuantiVirus™ HPV E6/E7 mRNA Test for Cervical Cancer (Branched‑chain capture hybridization; reports positive/negative for high‑risk HPV)	The primary Proprietary Laboratory Analyses (PLA) code for this specific test.
`88142`	Cytopathology, cervical or vaginal (e.g., Pap smear) by automated screening with manual rescreen and computer‑assisted interpretation	Often performed before or alongside HPV testing for cervical cytology screening and reflex testing pathways.
`87622`	Infectious agent detection by nucleic acid (DNA or RNA); human papillomavirus (HPV), high‑risk types (eg, types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68), multiplex real‑time amplification	Alternative high‑risk HPV nucleic acid test commonly used in screening algorithms; may be ordered instead of or in addition to mRNA testing depending on clinical protocols.
`88305`	Surgical pathology, gross and microscopic examination	Used if colposcopy with directed biopsy follows a positive `0502U` result; specimens are submitted for pathologic diagnosis.
`57454`	Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix	Diagnostic procedure commonly performed after positive high‑risk HPV or abnormal cytology findings.

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